| 1. |
- Bläckberg, Anna, et al.
(författare)
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Erysipelas, a large retrospective study of aetiology and clinical presentation.
- 2015
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Ingår i: BMC Infectious Diseases. - : Springer Science and Business Media LLC. - 1471-2334. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Erysipelas is a common and severe infection where the aetiology and optimal management is not well-studied. Here, we investigate the clinical features, bacteriological aetiology, and treatment of erysipelas.
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| 2. |
- Davidson, Kristina, et al.
(författare)
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Following the thread of Ariadne to the health of women
- 1996
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Ingår i: Health Care for Women International. - : Routledge. - 0739-9332 .- 1096-4665. ; 17:3, s. 201-208
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Tidskriftsartikel (refereegranskat)abstract
- The health of women has risen to a priority position in medical research. Comparative studies of female morbidity are called for as an intermediary stage for generation of hypotheses and design of deeper studies of determinants, such as social, ecological, and individual factors. In previous studies, we have noted differences in female hospitalization between Heraklion in Greece and Linköping in Sweden. They were related to age and to urban versus rural dwelling, and fit projections for a more archaic and a more technocratic society, respectively. This paper aims at showing how the study of women's health may proceed from relevant hospitalization observations to the next level, of exploring already available indicators of self‐perceived health in elderly females.
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| 3. |
- Fioretos, Michael, et al.
(författare)
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Hospital admissions in two European landscapes - comparison between Heraklion, Greece and Linköping
- 1993
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Ingår i: International Journal of Health Sciences. - 0924-2287. ; 4, s. 33-39
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Tidskriftsartikel (refereegranskat)abstract
- The study describes a comparison of hospital admissions during a two-year period between a regional hospital in Heraklion (Greece) and a regional hospital in Linköping (Sweden). The findings are considered mainly in terms of health care delivery and utilization in relation to various types of demographic factors.The results indicate that despite the different cultural and socio-economic environments in the studied districts, there are important similarities of hospitalisation pattern in the urban areas. However, there are also notable differences. The hospitalisation pattern seems to be more equally distributed between sexes and between urban and rural areas in Linköping (Sweden) than in Heraklion (Greece), where it appeared that the rural population, and women in particular, did not get hospital care according to their needs.
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| 4. |
- Trell, Kristina, et al.
(författare)
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Clinical and microbiological features of bacteremia with Streptococcus equi
- 2017
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Ingår i: Diagnostic Microbiology and Infectious Disease. - : Elsevier BV. - 0732-8893. ; 87:2, s. 196-198
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Tidskriftsartikel (refereegranskat)abstract
- Streptococcus equi (SE) rarely causes human infections. We identified 18 SE isolates from blood cultures. The focus of infection was unknown (n = 5), arthritis (n = 3), catheter-related (n = 2), pneumonia (n = 2), or other (n = 6). There were no fatalities. Several patients had animal contacts but there were no indications of clonal outbreaks.
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| 5. |
- Trell, Kristina
(författare)
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Clinical and molecular studies of β-haemolytic streptococci
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Beta-haemolytic streptococci (BHS) are important causes of human infections and they have traditionally been grouped according to Lancefield antigens. The spectrum of infections caused by BHS includes pharyngitis, skin infections, bacteraemia/sepsis, endocarditis, septic arthritis and meningitis. The most studied BHS is the group A Streptococcus (GAS), which concurs with the species Streptococcus pyogenes (SP). In the last decades, several studies have shown an increase of invasive infections caused by beta-haemolytic streptococci group C (GCS) and group G (GGS). GCS and GGS cause clinical disease similar to GAS. The vast majority of clinical isolates associated with human infections, that are identified as GCS and GGS belong to the species Streptococcus dysgalactiae (SD). With the introduction of Matrix assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF MS) in routine diagnostics, it became possible to determine species of GGS and GCS. GCS and GGS exhibit the M-protein, a known virulence factor in GAS infections. The M-protein is encoded by the emm-gene and sequencing of this gene can be used for typing purposes.In the first study, isolates of GCS and GGS from different sites of isolation (throat, wound, and blood) was species determined and emm-typed to investigate if certain types have a predilection to cause particular infections. We found that GCS and GGS express different emm-types and that GCS and GGS from different sites of isolation were similar, suggesting that emm-types are not associated to certain disease presentations.In the second study, subjects with recurrent bacteraemia with GCS and GGS were identified and compared to controls with only one episode of bacteraemia to detect risk factors for recurrence. In the 23 patients with recurrent episodes of SD bacteraemia, most recurrences were caused by the same emm-type suggesting a host-specific colonization. In addition, no specific emm-types or other clinical factors were significantly associated with recurrences.Among GCS causing human infections, isolates of Streptococcus equi (SE) have been found. In the third study, the clinical course of patients with bacteraemia with SE were described and the isolates were typed through sequencing of the gene encoding the M-like protein SzP. Eighteen cases of SE were found during a thirteen-year period, which confirms that SE is a rare cause of infection in humans. No temporal or geographical clustering was found in our material. Our study also indicated that sporadic cases of SE bacteraemia have a favourableprognosis.In the fourth work, we investigated the possibility of using cultures for diagnostic purposes by determining the perianal colonization with BHS in patients with erysipelas compared with a control group. In the group with erysipelas, 44% of the patients were colonized with BHS compared with 4 % of the patients in the control group. The BHS found were most commonly GGS and when subjected to MALDI-TOF MS, these were found to be SD. We concluded that SD colonizes the perianal area in a substantial proportion of patients with erysipelas.SP is a well-known cause of postpartum infections and is still causing significant morbidity and mortality worldwide. In the final study, we described the use of whole genome sequencing (WGS) to investigate an outbreak of postpartum SP emm75 infections related to an asymptomatic carrier working in a maternity ward. Source identification and WGS proved to be vital for outbreak control.
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| 6. |
- Trell, Kristina, et al.
(författare)
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Colonization of β-hemolytic streptococci in patients with erysipelas—a prospective study
- 2019
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Ingår i: European Journal of Clinical Microbiology and Infectious Diseases. - : Springer Science and Business Media LLC. - 0934-9723 .- 1435-4373. ; 38:10, s. 1901-1906
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Tidskriftsartikel (refereegranskat)abstract
- Erysipelas is a common skin infection causing significant morbidity. At present there are no established procedures for bacteriological sampling. Here we investigate the possibility of using cultures for diagnostic purposes by determining the perianal colonization with beta-hemolytic streptococci (BHS) in patients with erysipelas. Patients with erysipelas and a control group of patients with fever without signs of skin infection were prospectively included and cultures for BHS were taken from the tonsils, the perianal area, and wounds. BHS were grouped according to Lancefield antigen, species-determined, and emm-typed. Renewed cultures were taken after four weeks from patients with erysipelas and a positive culture for BHS. 25 patients with erysipelas and 25 with fever were included. In the group with erysipelas, 11 patients (44%) were colonized with BHS, ten patients were colonized in the perianal area, and one patient in the throat. In contrast, only one patient in the control group was colonized (p = 0.005 for difference). All of the patients with erysipelas colonized with BHS had an erythema located to the lower limb. The BHS were then subjected to MALDI-TOF MS and most commonly found to be Streptococcus dysgalactiae. Renewed cultures were taken from nine of the 11 patients with BHS and three of these were still colonized. Streptococcus dysgalactiae colonizes the perianal area in a substantial proportion of patients with erysipelas. The possibility of using cultures from this area as a diagnostic method in patients with erysipelas seems promising.
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| 7. |
- Trell, Kristina, et al.
(författare)
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Recurrent bacteremia with Streptococcus dysgalactiae: a case-control study.
- 2016
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Ingår i: Diagnostic Microbiology and Infectious Disease. - : Elsevier BV. - 1879-0070 .- 0732-8893.
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Tidskriftsartikel (refereegranskat)abstract
- Beta-hemolytic streptococci of groups C and G, designated as Streptococcus dysgalactiae (SD), can cause severe and recurring invasive infections. In this case-control study, we aimed to identify clinical and molecular risk factors for recurrence of SD bacteremia. Twenty-two cases of recurrent SD bacteremia were identified, and median time between episodes was 6 months. The most frequent clinical manifestation was skin and soft tissue infection. Cases and 92 controls, with single-episode SD bacteremia, showed similar demographics, had similar Charlson comorbidity scores, and had similar clinical presentations. Thirty-day fatality was 13% among controls, whereas none of 22 cases died. In 19 cases (86%), the same emm type was encountered in both episodes. SD isolates from recurrent episodes and from single episodes had a similar emm type distribution. Thus, we did not identify clinical risk factors for recurrences. The high proportion of identical emm types in recurrent episodes indicates a host-specific colonization.
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| 8. |
- Trell, Kristina, et al.
(författare)
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Species and emm-type distribution of group C and G streptococci from different sites of isolation
- 2016
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Ingår i: Diagnostic Microbiology and Infectious Disease. - : Elsevier BV. - 0732-8893. ; 86:4, s. 467-469
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Tidskriftsartikel (refereegranskat)abstract
- beta-Haemolytic streptococci of groups C (GCS) and G (GGS) from human infections typically belong to Streptococcus dysgalactiae and are important human pathogens. Among GGS (183 isolates), several emm-types were identified without significant differences between different sites of isolation. For GCS (79 isolates), the type-distribution was markedly different and more restricted.
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| 9. |
- Tsamandouraki, Kiki, et al.
(författare)
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Hospital admissions for different cancer diagnosis : a comparison between two European landscapes
- 1994
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Ingår i: Anticancer Research. - 0250-7005 .- 1791-7530. ; 14:5B, s. 2167-2170
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Tidskriftsartikel (refereegranskat)abstract
- Cancer frequency has been studied in a Department of Crete and a Department of Sweden, using in-patient data collected in the Departmental Hospitals, for a two-year period. The results of the study suggest that similar trends exist in the prevalence of different forms of cancer between the two areas studied, as well as some significant differences. The differences observed concern mainly the frequency of cancers of the lung, prostate, bladder and large bowel among men and breast and large bowel among women. These findings could to a great extent be explained by life-style and environmental differences between the two areas and are consistent with data concerning the cancer mortality in the two countries.
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